Do hip resurfacing and short hip stem arthroplasties differ from conventional hip stem replacement regarding impingement-free range of motion?

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Maeruan Kebbach - , University of Rostock (Author)
  • Christian Schulze - , University of Rostock (Author)
  • Christian Meyenburg - , University of Rostock (Author)
  • Daniel Kluess - , University of Rostock (Author)
  • Mevluet Sungu - , B. Braun Melsungen (Author)
  • Albrecht Hartmann - , University Hospital Carl Gustav Carus Dresden, University Center for Orthopedics, Trauma and Plastic Surgery (OUPC) (Author)
  • Klaus Peter Günther - , University Center for Orthopedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus Dresden (Author)
  • Rainer Bader - , University of Rostock (Author)

Abstract

Total hip joint replacement (THR) is clinically well-established. In this context, the resulting range of motion (ROM) is crucial for patient satisfaction when performing joint movements. However, the ROM for THR with different bone preserving strategies (short hip stem and hip resurfacing) raises the question of whether the ROM is comparable with conventional hip stems. Therefore, this computer-based study aimed to investigate the ROM and type of impingement for different implant systems. An established framework with computer-aided design 3D models based on magnetic resonance imaging data of 19 patients with hip osteoarthritis was used to analyse the ROM for three different implant systems (conventional hip stem vs. short hip stem vs. hip resurfacing) during typical joint movements. Our results revealed that all three designs led to mean maximum flexion higher than 110°. However, hip resurfacing showed less ROM (−5% against conventional and −6% against short hip stem). No significant differences were observed between the conventional and short hip stem during maximum flexion and internal rotation. Contrarily, a significant difference was detected between the conventional hip stem and hip resurfacing during internal rotation (p = 0.003). The ROM of the hip resurfacing was lower than the conventional and short hip stem during all three movements. Furthermore, hip resurfacing shifted the impingement type to implant-to-bone impingement compared with the other implant designs. The calculated ROMs of the implant systems achieved physiological levels during maximum flexion and internal rotation. However, bone impingement was more likely during internal rotation with increasing bone preservation. Despite the larger head diameter of hip resurfacing, the ROM examined was substantially lower than that of conventional and short hip stem.

Details

Original languageEnglish
Pages (from-to)2501-2515
Number of pages15
JournalJournal of orthopaedic research
Volume41
Issue number11
Early online date2 May 2023
Publication statusPublished - Nov 2023
Peer-reviewedYes

External IDs

PubMed 37132090

Keywords

ASJC Scopus subject areas

Keywords

  • hip joint replacement, impingement, implant design, range of motion, resurfacing

Library keywords